Legislature(2021 - 2022)DAVIS 106
03/01/2022 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HSCR2 | |
| Confirmation Hearing(s):|| Alaska State Medical Board | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HSCR 2 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
HSCR 2-DISAPPROVING EXECUTIVE ORDER 121
3:13:24 PM
CO-CHAIR ZULKOSKY announced that the first order of business
would be HOUSE SPECIAL CONCURRENT RESOLUTION NO. 2, Disapproving
Executive Order No. 121.
3:14:19 PM
CO-CHAIR ZULKOSKY opened public testimony on HSCR 2.
3:14:55 PM
MARIANNE MILLS, President, AGEnet, testified that AGEnet took a
position to support [Executive Order 121], which would
reorganize the Department of Health and Social Services (DHSS).
She reported that currently DHSS has a budget the size of 12
other departments, with a staff tally equaling six departments,
and a team of 5 manages 3,500 employees. She posited that
narrowing the scope of the agency would improve its ability to
effectively serve Alaskans. She asked the committee to oppose
HSCR 2.
3:16:28 PM
BOB PAWLOWSKI, Chair, Alaska Pioneer Homes Advisory Board,
testified that there is a $23 million deferred maintenance
backlog for the Pioneer Home program, and he shared his belief
that the program would be better served by being under a smaller
department. He added that dividing the department [as would
happen under EO 121, which HSCR 2 seeks to stop], would be
beneficial for the health and safety of the residents and
employees at the Pioneer Homes.
3:17:40 PM
JULIE SMYTH, representing self, testified in support of HSCR 2.
She stated that she receives services through DHSS and has not
received any information from the department about how dividing
the department would change those services. She opined that the
process to split DHSS should be stopped until such questions are
answered.
3:18:46 PM
ANDREE MCLOUD, representing self, testified in support of HSCR 2
as someone who cared for a person who received benefits from
DHSS. She argued that the executive order did not "pass muster"
and would upend the lives of many [vulnerable] people as well as
legislative authority. She spoke to points of concern she had
after listening to previous presentations from DHSS. Presenters
from DHSS had listed collaboration between departments to lower
costs through economy of scale purchases, and she questioned why
they were not already doing so. She mentioned that the division
directors reported a need to "clamor for the commissioner's
attention" as a large reason for dividing DHSS, and she argued
that the commissioner should be able to handle the requests
without needing to create an entire new department. She
reported that there was a lack of input from the Alaskans that
rely on the services provided by DHSS and quoted Commissioner
Adam Crum as saying that informing recipients of the change was
"not required." She referenced past department initiatives such
as the Wellpath rollout and the Medicaid adult dental preventive
program, which she described the department as having "messed
up," and she questioned whether that was the leadership that
should oversee the creation of a new department. She insisted
that the legislature should intervene in the governor's plan as
it would create "chaos" for the most vulnerable Alaskans.
3:22:14 PM
ROBIN O'DONOGHUE, Policy & Communications Manager, Alaska Public
Interest Research Group, testified in support of HSCR 2 and
cited lack of public participation as one of the largest issues.
He reported that there was a consensus that DHSS had many
problems, but it was unclear if bifurcation would solve them.
He said that high expense and creation of 13 new positions when
the state was in a fiscal and employee deficit was troubling.
He stated there had been a lack of communication between the
department and its beneficiaries, especially when there have
already been big changes in how Alaskans navigate their services
due to COVID-19. He characterized the department's testimony
about the proposal as confusing. He opined that the department
to be under-prepared to take on such an important split and that
many of the issues could be resolved internally while
maintaining one department. He expressed concern that following
through with the executive order would create a bad precedent
that the executive branch can reorganize large parts of the
state government with little input from the public or the
legislature, and he referenced a memorandum ("memo") from the
legislative legal division that said the executive order was an
example of overreach. He asked the committee to pass HSCR 2 to
give more time to properly investigate the proposal.
3:24:40 PM
LAURA BONNER, representing self, testified in support of HSCR 2
and mentioned that she had a disabled adult daughter who
received many services from DHSS. She believed that the
governor and commissioner have not provided enough compelling
evidence for why the split should happen at this time. She
stated that it was a huge and costly decision and should receive
more input from the legislature and the community before going
forward. She emphasized that the timing was not right and that
a change this large should not be considered at the end of the
governor's term.
3:26:42 PM
MIRANDA WALSO, Executive Director, Governor's Council on
Disabilities & Special Education, testified in opposition to
HSCR 2. She stated that to solve the issues DHSS was facing,
the state needed to increase its capacity at the highest levels.
She shared her belief that "things aren't getting better" and
that a larger change would be required. She opined that the
expansiveness of the regulations and services provided was too
diverse for one small group of people to handle, and there was a
pressing need to increase oversight.
3:28:36 PM
ED MARTIN, representing self, testified in support of HSCR 2.
He opined that splitting a department would not be cost-
effective. He questioned the zero fiscal note associated with
the executive order and stated that there would have to be an
addition of government positions either now or in the future,
which would cost the state money. He shared his concern over
how DHSS handled the COVID-19 crisis and stated that "this whole
department under [Commissioner] Crum has been out of control for
two years." He shared his belief that splitting the department
would lead to more opportunity for the department to "steal
liberties" from Alaskans. He urged the committee to stop the
governor's "overreach" by passing HSCR 2 out of committee.
3:30:35 PM
CO-CHAIR ZULKOSKY, after ascertaining there was no one else who
wished to testify, closed public testimony on HSCR 2.
3:31:00 PM
REPRESENTATIVE FIELDS stated that he was personally against the
bifurcation due to not enough collaborative stakeholder
engagement and the lack of an accompanying bill. He expressed a
need to make sure there was proper legislation for this
departmental change so that there was not a precedent for the
executive branch to rewrite large sections of statute through an
executive order. He opined that there needed to be more time
and thought put into the bifurcation process, and he advised
that a bill should be drafted for the next legislative session,
under the governor at that time. He emphasized the importance
of ensuring a balance between the powers of the legislative and
executive branches.
3:32:47 PM
REPRESENTATIVE MCCARTY commented that a common theme in the
discussions about the issues within DHSS was its management.
He shared how his personal experience working in health care has
left him very disgruntled about the management of the department
he has seen over the years, which he said has been mirrored in
the overall discussion. He said that the question was not
whether there are issues but how to fix them. He mentioned
several of the areas where DHSS has been struggling. He shared
that he was not opposed to bifurcation but would want to see it
accompanied by measurable goals for growth that show results
within a year. He stated that it was within the power of the
committee to create a bill that year to clean up the language of
the executive order and ensure it was moving toward the goal of
serving Alaskans.
3:36:07 PM
REPRESENTATIVE SPOHNHOLZ expressed agreement that there are many
issues in DHSS and that the department needs more capacity, but
she stated that the stakeholder engagement has been lacking.
She reiterated that engagement has been one-way, with
stakeholders feeling as though they were "essentially informed"
that there would be a division of the department, but that their
input on reorganization was not being considered. She argued
that the current offer was an incomplete package - an executive
order without companion legislation, which she described as
"absolutely necessary" for the success of the reorganization.
She posited that the executive branch did not submit the
companion legislation out of fear that the bill would be
"Christmas treed," but said it was her position that if adequate
stakeholder engagement had occurred, then there would have been
a lot of consensus and support for the executive order and its
legislation within the legislature. Instead of collaboration,
she reported hearing from people within the health care
community who fear that their relationship with the
administration and their mission within their work would be
jeopardized if they spoke candidly on the subject. She stated
that this is a problem because these community members run the
"mom and pop" or non-profit organizations that provide most of
the services that DHSS funds, and she explained that they cannot
do their work if they have a bad relationship with the
department.
REPRESENTATIVE SPOHNHOLZ characterized the proposal from the
administration as "half-baked" and said that by presenting it
without legislation, the governor was forcing the legislature to
fix the issues itself or even draw out the transition process
another year while creating the legislation. She stated that
transitions are already difficult but can be improved with solid
stakeholder engagement and an idea of what it will look like at
the end. She said that what the legislature was currently
presented with was a transition that would be "a slog without a
clear vista," and it is not clear what the state would be
getting out of it. She stated that she supported passing HSCR 2
to reject the executive order and approach the issue slowly and
methodically, with deep stakeholder engagement, and she
mentioned the $500,000 budget amendment to do more robust
engagement over the next year. She recommended that the
legislature invest in this approach because it would be a
smoother process that would yield a better product overall.
3:42:03 PM
REPRESENTATIVE PRAX spoke in opposition to HSCR 2 and stated
that the problems with the department have been known for over a
decade and that there had been as much research as there was
time for, so now the state needed to make a decision and move
on. He opined that the amount of work and detail put in by the
administration has been robust and included input from employees
within the organization from over many years. He posited that
the preparation was as good as it was going to get, and that
there was more risk in not following the executive order than
there was in following it.
3:43:58 PM
REPRESENTATIVE KURKA asked whether Mr. Dunmire from Legislative
Legal Services was still on the line for questions.
REPRESENTATIVE ZULKOSKY confirmed that Mr. Dunmire was
available.
REPRESENTATIVE KURKA voiced his understanding that the
Constitution of the State of Alaska does give the governor the
ability to split departments using an executive order, which
would automatically involve changing the statute. He asked Mr.
Dunmire if it would be possible to divide such a large
department through executive order without making policy calls
and changing statute.
3:46:52 PM
ANDREW DUNMIRE, Legislative Counsel, Legislative Legal Services,
Legislative Agencies and Offices, opined that it would not be
possible to split a principal department by executive order
without making policy changes through the process.
REPRESENTATIVE KURKA stated that the memorandum ("memo") that
Legislative Legal Services created addressed several sections in
the executive order that included unnecessary policy changes,
and he asked Mr. Dunmire to point these sections out. He
specifically mentioned Section 27 and asked for more information
about the Alaska Statues that would be changed by that section.
MR. DUNMIRE explained that during the drafting of the memo, he
compared each line of the executive order with existing statute
and made note of every policy change he saw, which were all
included in the final memo. He addressed Representative Kurka's
question about the policy change made under Section 27, which
decided that the new Department of Health (DOH) commissioner
would sit on the board of the Alaska Mental Health Trust
Authority (AMHTA). However, he explained that the executive
order also decided that the Alaska Psychiatric Institute (API)
would be overseen by the Department of Family Services (DFS),
meaning that the commissioner who oversees that program would
not have input into its regulatory board. He deferred to the
legislature to decide whether the policy changes he found were
unnecessary.
3:51:42 PM
CO-CHAIR SNYDER expanded on Representative Kurka's question and
stated it was a valid line of questioning that had been touched
on in previous testimony from the Department of Law (DOL) and
Legislative Legal Services. She reported that reorganization
and reassignment of a department through an executive order was
legal, but expansions or shrinking of authority were a gray
area. She mentioned that most of the issues were around
"problematic" wording that left too much open to interpretation
and listed board membership and areas of authority as two areas
of concern, but she said that these could be fixed with a piece
of companion legislature. She stated that legality aside, it
was now "in the legislature's court" to decide how to proceed
with the proposed bifurcation. She emphasized her commitment to
improve the functionality and oversight of the department and
her gratitude towards DHSS for the work accomplished so far.
However, she insisted that it was part of the committee's
responsibility to give the executive order due diligence and
that she continued to have several questions about moving
bifurcation forward that did not seem to have answers, which she
stated was a concern.
CO-CHAIR SNYDER cited continuous budget cuts to the department
since 2015 and opined that the state "shouldn't be terribly
surprised" about the persistent challenges the department was
facing. She listed workforce burnout, low rates of recruitment
and retention, and aging technological infrastructure as issues
that can be directly tied to DHSS budget volatility. She agreed
with Representative Prax's point that the issues are known and
further research into that was not needed but argued that the
proposal to bifurcate and add more positions would not solve the
identified problem. She emphasized the point made by other
members of the committee about the precedent that the executive
order would set and added that the legislature should consider
that precedent fully. She concluded by reiterating her support
for HSCR 2 and stated that moving it through in a timely manner
would allow the legislature to keep all its options on the table
to ensure it practices due diligence before enacting this
change.
3:59:05 PM
CO-CHAIR ZULKOSKY opined that the discussions around the
executive order revealed that a solution to the many programs
that are in crisis was crucial, as many of the stakeholders were
among Alaska's most vulnerable populations. She expressed that
DHSS had done an incredible job in demonstrating its many needs
in terms of providing services, but that she had not been
convinced that the executive order was the best solution. She
echoed the concerns of Legislative Legal Services that the legal
and fiscal ambiguities of the executive order could negatively
impact the future of the legislature as an institution. She
considered the 60-day deadline for a response on the executive
order as an inadequate amount of time to fully consider the
legal precedent, especially regarding the potential for
executive branch overreach.
CO-CHAIR ZULKOSKY returned to the topic of the executive order's
constitutionality and highlighted that the Legislative Legal
Services' memo revealed that there was very little authority on
the permissible scope of an executive order. She emphasized
that EO 121 dwarfs previous executive orders in size and scope;
allowing it to go into effect would signal that a reorganization
of this size was permissible and would cede a large portion of
the legislature's policy-making power to the executive branch.
She stated that legislative powers were bestowed solely on the
legislature by Alaska's constitution and that she was unable to
separate the incredible work DHSS has done from her concern
about the possibly substantive changes to statue included in EO
121 when Legislative Legal Services has advised that a bill
would be a more appropriate way to enact the governor's
proposal. She added that allowing the executive branch to usurp
the legislatures powers, whether intentional or not, would
violate constitutional checks and balances.
CO-CHAIR ZULKOSKY, having looked back at the last three fiscal
years, reported that the legislature had cut $30 million from a
number of DHSS divisions through the elimination of many "front-
line" service delivery positions. These cuts were made in favor
of six figure salaries and additional overhead in the creation
of a new commissioner's office, which was not a fiscal or policy
choice she supported. She expressed concern that if the state
were not able to deliver on the promise of a seamless transition
during bifurcation, then it would lead to the addition of
positions and massive unforeseen expenses that future
legislatures would have to address. She expressed her support
of moving HSCR 2 out of committee through a summary of her
concerns and stated that moving the resolution would promote
further dialogue within the legislature about this multi-faceted
issue.
4:06:10 PM
CO-CHAIR SNYDER moved to report HSCR 2 out of committee with
individual recommendations and the accompanying fiscal notes.
4:06:31 PM
REPRESENTATIVE PRAX objected.
4:06:36 PM
A roll call vote was taken. Representatives Spohnholz, Fields,
Kurka, Snyder, and Zulkosky voted in favor of the motion to
report HSCR 2 out of committee with individual recommendations
and the accompanying fiscal notes. Representatives McCarty and
Prax voted against it. Therefore, HSCR 2 was reported out of
the House Health and Social Services Standing Committee by a
vote of 5-2.
| Document Name | Date/Time | Subjects |
|---|---|---|
| David Wilson, Medical Board.pdf |
HHSS 3/1/2022 3:00:00 PM |
|
| Matt Heilala, Medical Board.pdf |
HHSS 3/1/2022 3:00:00 PM |
|
| EO 121, Letters of Support, 2.28.22.pdf |
HHSS 3/1/2022 3:00:00 PM |
|
| AMHB.ABADA EO 121 LOS Final.pdf |
HHSS 3/1/2022 3:00:00 PM |
EO 121 |
| HSCR 2, Fiscal Note.pdf |
HHSS 3/1/2022 3:00:00 PM |
HSCR 2 |